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Background Clinical and biochemical impacts on liver
dysfunction, as manifested by an increase in serum transaminase
levels, are common in dengue infection. Howevei; an association of
elevated serum transaminase and dengue shock syndrome (DSS)
has n ot been well-established.
Objective To assess for an association between serum transaminase
levels and the presence of DSS in children.
Methods A nested, case control study was conducted on children
aged l month to 12 years admitted to Sanglah Hospital who
were diagnosed with dengue infection. Baseline characteristics
and serum transaminase levels were recorded. Patients who were
included in the study were observed for the presence of DSS.
Those who had DSS were selected as cases, and those who did not
develop DSS were selected as controls. Data was analyzed using
bivariate and multivariate methods with 95% confidence intervals
and P value <0.05 was considered as statistically significant.
Results Ninety-four children were involeved, 4 7 children in the
case group and the other 4 7 were in the control group. Baseline
characteristics of the subjects were similar between the case and
control groups. Serum aspart ate transaminase (AST) level of
2:: 128 U/L and alanine transaminase (ALT) of 2: 40 U/L were
associated with DSS (OR 10; 95%CI 2.3 to 44.4; P=0.002) and
(OR 7 .3; 95%CI 1.6 to 32.9; P= 0.009), respectively.
Conclusion Elevated AST and ALT levels were associated
with an increased risk of DSS in children with dengue infection.
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